Rural vaccinations pick up pace, but rural districts still underserved

Although rural districts account for 41.7 per cent of the country's population, their share in total doses is just 35 per cent

A “free for all” vaccination policy has indeed made a difference to vaccination rates across the country. Not only has the pace of vaccination picked up, the distribution of vaccines has also become a little more equitable ever since.

While India had administered only 284 million vaccines until June 21, it has since covered 483 million people with the first dose, and 143 million with the second dose. In all, 626 million doses have been administered across the country.

The government crossed the 10 million daily vaccination mark on August 27 and averaged 7.04 million vaccines daily as against the 7-day average of 3.48 million until June 21.

A Business Standard analysis shows that administration of doses in rural districts has jumped 2.5 times since June 21. Until June 21, rural districts in the country (with less than 20 per cent population residing in urban areas) had administered 16.9 doses per 100 people. On August 28, the ratio of administered doses was 41.6. In semi-urban districts, the increase was 2.4-times, from 19.6 doses to 46.3 doses per 100 people. Urban centres rose relatively slowly at 2.1 times, with doses rising from 27.6 to 59.1 per 100 people.

While rural districts are apportioning more doses since June 21, there is still a considerable divide between rural and urban centres. Urban districts still account for 46.1 per cent of the total administered doses. Even though this ratio has decreased from 49 per cent, the corresponding increase in rural areas is just 2.3 per cent since June 21. Semi-urban centres (with 20-30 per cent population residing in urban areas) have witnessed a mere 0.5 per cent increase in allocation.

In terms of daily doses, urban districts still account for over two-thirds of allocated vaccine doses. One-fifth of the vaccines have been administered in semi-urban centres, whereas the rural areas account for a third of the total allocation.

The relative population shares of urban, semi-urban and rural districts according to the 2011 census are 38.2 per cent, 20.1 per cent and 41.7 per cent, respectively. So, rural areas need to receive at least 41.7 per cent of the doses to make vaccine administration more equitable. But till now, rural areas have only received 35.1 per cent of the vaccine doses.

There is a significant state-wise variation in the administration of vaccine doses as well.

Odisha, for instance, has 71 per cent of its population residing in rural districts, but has administered only 61 per cent of its doses in rural districts.

Haryana has a gap of 7.2 per cent between doses administered and population. While 18.1 per cent of its population resides in rural districts, in terms of vaccine doses, only 10.9 per cent of the total doses have been administered in rural areas.

In West Bengal, the gap is 7.1 per cent; it is 5.7 per cent in Madhya Pradesh and 5.2 per cent in Bihar. In Karnataka, the gap is only 1 per cent, and it is 1.6 per cent in Maharashtra.

Kerala, Chhattisgarh, Tripura, Himachal Pradesh and Uttarakhand have performed better, with more doses being administered in rural districts. In Kerala, the gap is negative 2.3 per cent, i.e., rural districts have received 2.3 per cent more doses than their share in the total population. Chhattisgarh is even better with a 4.8 per cent gap favouring rural areas, and Uttarakhand tops all states with a 10 per cent gap favouring rural districts.

As the fear of a third wave looms, India needs to ensure that vaccines reach rural and semi-urban districts, as these districts are deficient in healthcare infrastructure.